Download The effect of aerobic continuous training and detraining on left

2017
02
The effect of aerobic continuous training and detraining on left
ventricular structure and function in male students
Javad Mahdiabadi1, Mohammadali Mahdiabadi2, Toba Kazemi3
Belarusian State University of Physical Culture, Minsk, Belarus
2
Birjand University of Medical Sciences, Birjand, Iran
3
Birjand Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Science, Birjand, Iran
1
Abstract
Purpose:
Material:
Results:
Conclusions:
Keywords:
Regular exercise training induces cardiac physiological hypertrophy. The aim of this study was to determine
the effect of aerobic continuous training and a detraining period on left ventricular structure and function in
non-athlete healthy men.
Ten untrained healthy male students (aged 18-22 years) were volunteered and participated in countryside
continuous jogging programme (3days/week, at 70% of Maximum Heart Rate for 45 min, 8-weeks) and four
weeks detraining afterwards. M-mode, 2-dimensional, colour and Doppler transthoracic echocardiography
were performed, during resting conditions, before and after the training and after detraining period.
Using t-test, we found significant difference in end systolic diameter and the posterior wall thickness,
percentage shortening and ejection fraction after eight weeks training compared to before training. It was
found no significant difference in end diastolic diameter, interventricular septum thickness, left atrium
diameter, aortic root diameter, heart rate, systolic and diastolic blood pressures. Following four weeks
detraining after training, compared with eight weeks of training was a significant difference in end diastolic
diameter, percentage shortening and ejection fraction and no significant difference in end systolic diameter,
posterior wall thickness, interventricular septum thickness, left atrium diameter, aortic root diameter, heart
rate, systolic and diastolic blood pressures.
In general, eight-week aerobic continuous training and a detraining period can affect left ventricular structure
and function.
Key words: aerobic exercise, detraining, left ventricular function, echocardiography, health people.
Introduction1
Physical training causes structural and functional
changes in the heart, particularly in the left ventricle
[14, 22, 25]. These changes constitute the cardiac
adaptability phenomenon following the physiological,
in contrast with the pathological changes brought about
by hypertension and aortic stenosis [26]. In the case
of disease, the heart confronts elevated pressures, but
physiologically such pressures affect the heart only
during physical training. The impact of physical training
on cardiac structure and function depends on type,
intensity and duration of training, as well as previous
physical fitness, genetics and gender [4]. Continuous,
long-term physical activities exert an overload on cardiac
muscles, resulting in an exogenous hypertrophic pattern
with normal ventricular walls and increased ventricular
(especially left ventricular) volume [7, 25]. In addition,
these individuals have greater diastolic filling volume,
left ventricle diameter and mass, ventricular capacity,
and stronger myocardial contraction, as explained by the
Frank-Starling law [6]. Studies have indicated that all
cardiac morphological parameters return to pre-training
values after the detraining period [9, 19].
Rodrigues et al. [21] assessed the effects of 6 months
of moderate-intensity aerobic training (1 hour/day, 3
times/week) on normal hearts, 23 sedentary men aged
31.1 +/- 3.5 years. After training, there was a significantly
decrease in heart rate and significantly increase in Septal
and posterior wall thickness. LV diameters and ejection
fraction were unchanged. Obert et al. [15] in study on 25
children (11 girls, 14 boys) were enrolled in a 2 month
high-intensity aerobic training program and 25 (12
girls and 13 boys) served as controls noted significant
increase in left ventricular end-diastolic diameter,
whereas left ventricular wall thickness and mass were
unchanged. Shortening fraction and regional systolic
function were also unchanged. Tjonna et al. [24] found
that aerobic interval and continuous training on average
three times a week on a treadmill for 16 weeks reduced
systolic and diastolic blood pressure in patients with
metabolic syndrome. Ciolac et al. [1] investigated the
acute effects of continuous and interval aerobic exercise
on 24-h ambulatory blood pressure in long-term treated
hypertensive patients. They observed a decrease in mean
24-h systolic and diastolic blood pressure. Obert et al.
[16] In a study on twenty-nine 10-11 year old boys and
girls participated in a 13-week running program (3 x 1 h/
week, intensity: > 80% HRmax) as well as after 2 months
of detraining showed that LV internal chamber dimension
increased (+ 4.6 %, p < 0.01) while wall thicknesses
concomitantly decreased (-10.7%, p < 0.05) after training
and all cardiac morphological parameters returned to pretraining values after detraining.
Many studies have been performed on competitive
athlete’s heart and most studies have investigated the
effect of intense continuous training. One of the most
important effects of regular physical training is the
adaptation of the cardiovascular system. The basic
importance of an “athlete’s heart” is manifested in two
© Javad Mahdiabadi, Mohammadali Mahdiabadi,
Toba Kazemi, 2017
doi:10.15561/20755279.2017.0202
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OF STUDENTS
fields: public health and competitive sport. Low intensity
training is the most appropriate and the least dangerous
type of physical load to maintain an optimal state of health
of an individual. Considering the limitations in studying
continuous training with low intensity and detraining, the
present study was designed to assess its effects on the left
ventricular structure and function in untrained healthy
males.
Material and methods
Participants. The study was performed on ten nonathletic male students of the Azad Islamic University
of Birjand (Iran) aged from 18 to 22 years (20.5 ± 1.58
years, 72.65 ± 9.19 kg, 174.2 ± 6.40 cm), took part in the
study. The study protocol was approved by the research
ethics committee of Payame Noor University of Tehran
and was carried out in accordance with the Declaration of
Helsinki. Each participant gave informed consent before
enrolment. The students were not professional athletes
and did not have any sports category. The criterion for
cardiovascular health was the data obtained from the
questionnaire devised by the researcher. Subsequently,
the subjects’ ECGs were studied to confirm their cardiac
health. Before the initiation to participate in the study, the
subjects were informed of the process and filled out the
medical sport questionnaire and the consent form.
Training programme. Training programme was
designed including a 45-minutes countryside continuous
jogging with 70% of the maximum heart rate (MHR),
three times a week for eight weeks. The subjects warmed
up for 10 min before starting the main programme, and
cooled down for 10 min after the main programme. All
the training sessions were supervised by the researcher.
After eight weeks of training, four weeks detraining was
considered.
Echocardiography. The subjects had echocardiographic
examinations before and after eight weeks training and after
four weeks detraining. Before echocardiography, the students’
anthropometric data were taken into consideration (height,
cm; weight, kg). Ultrasonic examination was carried out
before and after continuous training and detraining at rest. In
the examination the wall thickness of the left ventricle and its
cavity diameters were measured: left ventricular end diastolic
dimension (LVEDD, mm); left ventricular end systolic
dimension (LVESD, mm); percentage ejection fraction (%);
percentage shortening fraction (%); interventricular septum
thickness (IVST, mm); left ventricular posterior wall thickness
(LVPWT, mm) left atrium diameter (LA, mm) and aortic root
diameter (AO, mm). The thickness of walls was measured
in the diastolic phase of the cardiac cycle.
These variables were measured at the echocardiography
ward in the Birjand Vali-asr Hospital by a cardiologist.
Echocardiographic examination was carried out on the unit
Esaote Biomedica (Italy) with application of M-modal,
two-dimensional color and Doppler transthoracic [5, 10].
The heart beat while resting was measured by
60-s count, Systolic blood pressure (SBP, mm Hg) and
diastolic blood pressure (DBP, mm Hg) were measured
with mercury blood pressure devices of Richter model no
more than 2 times with 2–3-minute intervals on the right
hand with the subject in the sitting position.
Maximum heart rate was determined by the formula:
HRmax = 220 beats/min − age.
Statistical Analysis. Descriptive statistics, a t-test for
paired data was used to assess differences between preand post-tests as well as detraining, and P equal to or less
than 0.05 was considered as the significance level. Data
normality was checked with Kolmogorov – Smirnov test.
Results
Absolute values of cardiac structural features of the
subjects are summarized in Table 1. The end systolic
diameter decreased and the posterior wall thickness,
percentage shortening and ejection fraction increased
significantly after training (P≤0.05). The end diastolic
diameter, percentage shortening and ejection fraction
decreased significantly after detraining (P≤0.05). The
end diastolic diameter after training and the end systolic
diameter after detraining did not change significantly
Table 1. Absolute values of left ventricle structural and functional features of the subjects (Means ± SDs)
Variables
Before training
After 8-weeks training
After 4-weeks detraining
LVEDD (mm)
LVESD (mm)
FS (%)
EF (%)
IVST (mm)
PWT (mm)
LA (mm)
AO (mm)
HR (bit/min)
SBP (mmHg)
DBP (mmHg)
48.8 ± 4.7
32.3 ± 2.8
33.5 ± 5.1
64.6 ± 6.7
9.8 ± 1.8
7.1 ± 1.1
27.1 ± 3.6
25.5 ± 2.5
73.4 ± 9.0
120 ± 11.7
74 ± 9.6
49.4 ± 3.9
29.2 ± 4.5**
40.2 ± 5.7***, ᴪᴪ
70.1 ± 7.0***, ᴪᴪ
10.12 ± 1.8
8.0 ± 1.4*
27.8 ± 4.0
24.9 ± 2.1
71.2 ± 6.1
116 ±11.7
71.5 ± 9.4
46.7 ± 3.9
31.3 ± 2.1
32.2 ± 3.8
60.3 ± 5.4
9.5 ± 1.9
7.4 ± 1.0
27.4 ± 4.9
26.1 ± 3.6
77 ± 9.0
115.5 ± 13.1
70.5 ± 11.6
ᴪ
Notes: ***, **, *: significantly differ­ent from pre-training values at p<0.001; p<0.01; p<0.05; ᴪᴪ, ᴪ: significantly different
from detraining values at p<0.01; p<0.05.
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(P>0.05). No significant difference was observed in the
interventricular septum thickness, left atrium diameter,
aortic root diameter, heart rate, systolic and diastolic
blood pressures after eight week training and also after
four week detraining (P>0.05).
aerobic training. Increase in diameter of posterior wall
and interventricular septum thickness is probably due to
an increase in the left ventricular mass index, which can
be regarded as an adverse precursor of left ventricular
hypertrophy. After detraining interventricular septum
thickness and posterior wall thickness decreased no
significantly.
After eight weeks training the left atrium diameter
(LA) showed no significant change. Also after detraining
not observed significant change in LA. The aortic root
diameter (AO), after eight weeks training decreased
no significantly and after detraining increased no
significantly. Several studies have shown that structural
and functional changes in the left ventricle during exercise
are higher greater than in other parts of the heart [14, 20,
26]. Therefore, the training performed in this study was
not effect on LA and AO.
After eight weeks training the resting heart rate (HR)
decreased and after four weeks detraining increased no
significantly. Meyer et al. [12] observed increase in the
heart rate after training. On the other hand, Rodrigues et al.
[21] showed decrease in heart rate after aerobic training.
Systolic and diastolic blood pressure after training and
detraining decreased no significantly. Tjonna et al. [24]
Ciolac et al. [1] noted a decrease in systolic and diastolic
blood pressure after training, Park et al. [18] founed
significantly decrease in systolic blood pressure after
aerobic exercise and Shiotani et al. [23] noted a significant
decrease in heart rate and no significant changes in blood
pressure. In training and competition, endurance-trained
athletes sustain long intervals with high cardiac output,
high heart rate, high stroke volume and a moderate increase
in mean arterial blood pressure. Dynamic exercise imposes
a volume load on the left ventricle. The cardiac output of
trained endurance athletes may increase from 5 to 6 l/min
at rest to up to 40 l/min during maximal exercise. Besides
an increase in cardiac output, the blood pressure increases
as well, although not to the same extent as during strength
training [13]. Lack of change in heart rate, systolic and
diastolic blood pressure variables in this study may be due
to insufficiently long training and non-athletic subjects.
Overall, these contradictory results are probably due to
differences in training duration, subjects, experience,
ethnicity, and gender. To obtain greater effectiveness, it
may be recommended that researchers choose subjects
with more available time (full time subjects) and conduct
the study on a longer period of time.
Discussion
In the present study, following eight weeks
continuous training the left ventricular end diastolic
diameter increased no significantly and the end systolic
diameter decreased significantly. Rodrigues et al. [21],
Park et al. [18] reported no significantly change in the
end diastolic diameter and end systolic diameter after
aerobic exercise. Conraads et al. [2] showed a decrease in
left ventricular end-systolic diameter in the trained heart
failure group. Aerobic activities bring about a volume
overload which increases the initial diastolic filling at
rest and exercise. Decrease of left ventricular systolic
diameter after aerobic training may indicate a decrease in
residual blood volume in the left ventricle. This implies a
better emptying of the ventricle with each systole and as
a result of exercise with volume overload on left ventricle
[17]. After four weeks of detraining the left ventricular
end diastolic diameter decreased significantly and the end
systolic diameter had no significant increase. Changes in
left ventricular dimensions after detraining shows that,
the effects of training on left ventricle returned to that of
before training.
Percentage shortening fraction (FS %) and percentage
ejection fraction (EF %) increased significantly after
training. D’Andrea et al. [3] observed a significant
increase in percentage shortening fraction. Haykowsky
et al. [8] observed a significant increase in percentage
ejection fraction. On the other hand, Park et al. [18]
did not observe significant differences in percentage
shortening fraction and percentage ejection fraction after
aerobic exercise. The significant increase in myocardial
contractility could be due to the decreased left ventricular
end systolic diameter after training and as a response to
the increase in the stroke volume. Thus, increase in the
percentage the shortening fraction of the left ventricular
muscle fibres showed indicated an increase in the volume
of blood pumped by the left ventricle at each of the left
ventricular contraction. These results show increased
percentage ejection fraction after eight weeks of training
and indicates the superiority of left ventricular function
after exercise. There was a significant decrease after four
weeks detraining in FS% and EF%.
During endurance training, heart needs to adapt to
both volume and pressure load. The heart responds by
increasing left ventricular internal diameter and left
ventricular wall thickness. Hence the heart responds
predominantly with eccentric hypertrophy [11, 13]. After
8 weeks of training, there was no significant increase in
interventricular septum thickness and significant increase
in posterior wall thickness. Rodrigues et al. [21] reported a
significant increase in Septal and posterior wall thickness
after aerobic training. Obert et al. [15] noted that the left
ventricular wall thickness and mass were unchanged after
Conclusions
In conclusion, increase in diastolic diameter and
decrease in systolic diameter shows a volume overload on
left ventricle and an enlargement of LV internal chamber
dimension and an increase in wall thickness. Thus changes
in the thickness of the septum and posterior wall represent
the heart adaptations to an excessive stress caused by
training program application and increase in left ventricle
mass. Increase in the parameters of the cardiac contractile
function suggests that the continuous jogging program
favors the cardiac muscle strengthening. Eight weeks
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aerobic continuous jogging can cause physiological
hypertrophy of left ventricle in non-athletes healthy male,
systolic function of subjects improves after training and
decreases after four weeks detraining. In general, this
training program can appropriate and effective training
method to improve cardiovascular function, particularly
left ventricular function in healthy people.
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Conflict of interests
The authors declare that there is no conflict of interests.
2017
02
Information about the authors:
Javad Mahdiabadi; http://orcid.org/0000-0002-2442-3206; [email protected]; Ph.D student of Exercise Physiology,
Belarusian State University of Physical Culture; Pobediteley Ave., 105, Minsk, 220020, Republic of Belarus.
Mohammadali Mahdiabadi; http://orcid.org/0000-0002-9231-9718; [email protected]; MD, Assistant Professor of
Internal Medicine, Birjand University of Medical Sciences; Ayatollah ghafari street, Birjand, Iran.
Toba Kazemi; http://orcid.org/0000-0002-6204-4514; [email protected]; MD, professor of cardiology, Birjand
Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Science; Ayatollah ghafari street, Birjand, Iran.
Cite this article as: Javad Mahdiabadi, Mohammadali Mahdiabadi, Toba Kazemi. The effect of aerobic continuous
training and detraining on left ventricular structure and function in male students. Physical education of students,
2017;2:61–65. doi:10.15561/20755279.2017.0202
The electronic version of this article is the complete one and can be found online at: http://www.sportedu.org.ua/index.php/PES/issue/archive
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution,
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Received: 11.01.2017
Accepted: 21.01.2017; Published: 04.04.2017
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